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Canada should offer heroin to addicts

Treat drug abuse the same as any other medical condition, former MP John Reynolds suggests

Canada should be willing to offer prescription heroin for intractable addicts – the same as any other treatment for a medical condition, a high-profile federal Conservative says.

Former MP John Reynolds, who co-chaired Prime Minster Stephen Harper's 2006 election campaign, is a director of the charity that is fundraising for a new medical trial that will provide heroin and a substitute narcotic in Vancouver and Montreal.

“If we can show this works, why wouldn't we move towards that kind of help for people who are addicts,” Mr. Reynolds said in an interview Monday. “Is there really any difference from one disease to another? From one addiction to another?”

The federal Conservatives have offered little encouragement for harm-reduction policies when it comes to illicit drug use. Mr. Harper has opposed Vancouver's safe injection site, Insite, and has favoured prevention and a tough-on-crime outlook: “If you remain a drug addict, I don't care how much harm you reduce, you are going to have a short and miserable life,” he said in 2007.

But Mr. Reynolds, a member of the InnerChange Foundation in Vancouver, applauded the research arm of Health Canada for financing the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), which will offer heroin and a legal substitute, Hydromorphone.

“Anything that thinking people can do to help people get rid of that illness is a good idea,” he said. “This is non-partisan thing, this is about people helping people.”

Eugenia Oviedo-Joekes is part of the research team that will be running the clinic in Vancouver, which is expected to be open by the end of the year.

The key to the research is to determine if heroin addicts will accept an alternate narcotic that is legally available in Canada, she said. In a secondary phase, some of the 200 addicts who will be recruited to the program will be offered heroin in a pill form - another way of reducing the stigma and health risks associated with injecting drugs.

She said a growing body of medical data shows that heroin treatment is effective - both for the patients and for the community - but the provincial and federal governments have been reluctant to accept the evidence.

“The sad part is that heroin works and we don't have the authorization to do it,” she said.

Ms. Oviedo-Joekes worked on an earlier Canadian heroin trial that wrapped up last summer, the North American Opiate Medication Initiative (NAOMI). The researchers' found that patients recruited from the ranks of addicts who had failed to respond to existing treatment like methadone were healthier and committed fewer crimes to pay for their habits.

“We really hope with SALOME that if we can show (Hydromorphone) is as effective, there will be so many fewer obstacles to treatment - because it is not called heroin.”

The new trials will be conducted at the same clinics used for the NAOMI research. The clinic in Vancouver has been kept open for methadone treatment, but is ready to return to its previous function, said Dr. David Marsh, an addiction medicine expert with the Vancouver Coastal Health Authority. “The physical space is available any time; it probably needs a fresh coat of paint.” However, he said there are still several regulatory hurdles to cross, including approvals to import heroin from Europe.

Criminologist Neil Boyd of Simon Fraser University, who studied the community impact of the NAOMI project, said the neighbours found little reason to fear the heroin clinic. “When you combine our findings with the findings of the NAOMI study, it's pretty clear not only do the people in the program benefit, but we all benefit: The participants are involved in less crime and there is no impact on the community,” he said.

But he said he would be surprised if the Harper government is moved to change its approach to drug addiction by the clinical findings.

“The idea of providing drugs in whatever form is something they have reacted quite strongly against.”